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Case presentation A 65-year-old Asian man with alcoholic cirrhosis complicated by esophageal varices was admitted to Saga Medical School Hospital's emergency division in early August, suffering from acute pain, redness, swelling, and purpura of the lower extremities. Gram-negative rods were morphologically compatible with V. vulnificus, according to the Gram stain of the little amount of discharge from the test lesion's surgical incision. Before the patient underwent emergency surgical intervention, a patient was immediately treated with two sets of blood culture, intravenous meropenem, and minocycline. Both blood culture and wound culture recovered Gram-negative rods, which were later identified as V. vulnificus by mass spectrometry, matrix-assisted laser desorption/ionization. Conclusion The pre-test probability of V. vulnificus infection was further strengthened by on-site Gram staining in the emergency division, which was even more convincing.
Source link: https://doi.org/10.1186/s13256-022-03731-x
Objectives: The purpose of this prospective research was to investigate the various microorganisms associated with mortality, to assess the bullous skin sign, and to identify the key risk factors for distinguishing necrotizing fasciitis from cellulitis on first arrival at the emergency department. Results: A total of 15 patients in the NF group and two patients in the cellulitis group died, with a mortality rate of 10. 3% and 1. 3%, respectively. The NF group had a significantly higher risk of white blood cell counts, band form neutrophil, and C-reactive protein than patients in the cellulitis group. Conclusion: The following diagnostic tools can be used to distinguish NF from cellulitis at the start of the disease: presence of hemorrhagic bullae, white blood cell counts > 11,000 cells/mm3, and systolic blood pressure > 1% at the time of consultation.
Source link: https://doi.org/10.1016/j.ijid.2022.12.012
According to B. breve, there have been only few cases of necrotizing fasciitis caused by B. breve. Case description: A 42-year-old Japanese man with type 2 diabetes mellitus, obesity, cellulitis of the back, and subcutaneous absces of the right inguinal area was detected quickly causing erythema, swelling, and severe pain in the right inguinal region. Conclusion: B. breve can cause necrotizing fasciitis, especially in imcompetent hosts.
Source link: https://doi.org/10.1016/j.idcr.2022.e01667
Abstract Bikram Das Background Bikram Background: Aeromonas is a water-dwelling Gram-negative bacillus most commonly associated with gastrointestinal tract diseases. In India, Aeromonas sobria causing gastroenteritis has been reported. Aeromonas sobria, an immunocompromised host, can also be present with severe necrotizing skin and soft tissue infections with a high mortality rate. We report a case of Aeromonas sepsis with skin and soft tissue infections as a result of immunosuppression. Case Presentation The fifty-year-old male who underwent unrelated donor peripheral stem cell transplant for relapsed pre-B acute lymphoblastic leukemia in complete clinical remission of graft versus host disease prophylaxis, post-white blood cell engraftment was seen with acute onset lethargy, lower leg pain without fever, or any skin changes initially. Conclusion Aeromonas should be considered a source of sepsis in immunosuppressed hosts, especially those with necrotizing skin and soft tissue infection.
Source link: https://doi.org/10.1055/s-0042-1743164
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